Medicare and Medicaid Cuts, and Paying for Your Own Long Term Care

66% of residents in an assisted living facility in 2009 reported being the primary source of payment for the costs of housing and care. The impact of the economic recession has hit seniors and their families hard with an almost 60% drop in the number of families able to contribute to a loved ones care. The trend of more seniors being solely responsible for the costs of housing and care will only be made worse as the combination of a slow economic recovery and additional cuts to programs such as Medicare and Medicaid are being contemplated as part of President Obama’s health reform plans.

Over the coming years these economic and political realities will be exacerbated by the baby boomers reaching retirement age and then their “senior living” years (shifting to use of home healthcare, assisted living and skilled nursing home care). Cuts to programs such as Medicare and Medicaid may be shortsighted. During a recent interview with healthcare policy expert Gail Wilensky on PBS’ News Hour (Aug. 10), her insight into the impact of these cuts was very specific:

GAIL WILENSKY: The notion that you can cut $500 billion to $600 billion dollars out of the Medicare and Medicaid program and think that you don’t risk affecting access for groups of seniors is simply incorrect. That is a whole different story. What most of the ways to get money quickly, which is what you want if you want to use that money to expand insurance coverage for people don’t have it, are sure ways that Congress will score as being a real saving, and that means whacking reimbursement. They’re going to lower reimbursements for a nursing home. They’re going to lower reimbursements…

JUDY WOODRUFF: For nursing homes?

GAIL WILENSKY: … for nursing homes, for home care. They’re going to reduce the amount hospitals who have high re-admissions for certain illnesses have. Now, do you want to go after some of these in reforming the delivery system? You do in careful and slow ways, but just whacking reimbursement, which is the only way to get quick savings upfront, is a whole different matter.

There is no doubt that our nation’s healthcare system needs reform, but before cutting real dollars to provide care to our nation’s most vulnerable population, areas to concentrate on first are administrative waste, unnecessary medical testing, frivolous law suits, and excessive drug and medical equipment costs. Regardless of the outcome of this latest attempt to reform healthcare, seniors and their families must prepare themselves to shoulder more and more of the burden of the costs for senior housing and care. Private funding sources are going to continue to become the rule and not the exception as time moves along.